Peptic ulcer bleeding in patients with or without cirrhosis: different diseases but the same prognosis?

Background Physiopathology and prognosis of peptic ulcer bleeding (PUB) have never been described in cirrhotic patients. Aim To assess risk factors and outcome of PUB in two groups of patients with PUB with or without cirrhosis. Methods We included prospectively all patients with PUB referred to our ICU of Hepatology and Gastroenterology between January 2008 and March 2011. All patients were treated according to international recommendations. Diagnosis of cirrhosis was based on clinical, biological and morphological exams. Aetiologies, characteristics and outcomes of PUB were compared in cirrhotic vs. noncirrhotic patients. Results A total of 203 patients with PUB were included prospectively. Twenty-nine patients had cirrhosis (group Cirr+), and 174 patients had no cirrhosis (group Cirr-). Demographic data were similar between the two groups except for age and alcohol consumption. Aetiology of cirrhosis was alcohol in 97% of cirrhotic patients. Characteristics of PUB were not different between the two groups. Ninety-three per cent of patients with cirrhosis had endoscopic portal hypertension. Aetiology of PUB was different between the group Cirr+ and Cirr- (Helicobacter pylori similar to=similar to 10.3% vs. 48.8%, P similar to